Planning & Zoning Commission (linked)

Town of Waterford
Department of Planning and Development 
www.waterfordct.org 
 
 
 
 
 
Informal Staff Review  
 
Site Plan/Design Review 
 
Municipal Project (CGS§8-24) 
Special Permit/Design Review1  
Subdivision /Resubdivision 
 
Lot line Adjustment 
 
 
Zoning Map Change 
 
 
Regulation Amendment(s) 
 
New District
Multifamily Development 
 
Coastal Area Management 2 
 
Earth Excavation  
Flood Hazard Area 
 
 
Other: ___________________  
Other: ___________________ 
Specify all uses and corresponding section for which this application applies3: 
Use:  _______________________________________ 
Section: ____________________________________________ 
Use:  _______________________________________ 
Section: ____________________________________________ 
Use:  _______________________________________ 
Section: ____________________________________________ 
Name of proposed development/subdivision: ____________________________ If subdivision how many lots?: _______  
If applicable, are roadways proposed to be private, public or both: 
Private  
 
 
 
Public  
 
 
 
Both4
Parcel 1 
 
 
 
 
 
 
Parcel 2
Map/Block/Lot:   ____/____/____    ____/____/____ 
 
Map/Block/Lot:   ____/____/____    ____/____/____ 
Street No. & Name: 
_______________________  
 
Street No. & Name: 
_______________________  
Size SF/AC:  ___________/___________ 
 
 
Size SF/AC:  ___________/___________  
 
Zoning District(s): __________________ 
 
 
Zoning District(s): __________________ 
                                                          
1 Include a completed list of property owners with Parcel ID, name, address and mailing address.  It is the applicant’s responsibility to distribute all 
notices certified return receipt.  Evidence of mailing shall be submitted prior to the start of the hearing.  Failure to do so will delay the opening of the 
hearing. 
2 Coastal Site Plan reviews under Coastal Area Management §25.4 must submit a completed PZC Form 2 in addition to this PZC Form 1. 
3 The use listed must correspond to the exact use term noted within the zoning district as a permitted use allowed through site plan or special permit.
4 A plan must accompany the application clearly delineating the limits of public and private roads. 
PZC Form 1
Planning and Zoning Application
1.
Type of Application(s), Use and Property Information (check all that apply)
Office Use Only
Date Submitted:___________ 
Processed By:_____________  
App. No.: ________________ 
Total Fee: $_______________
Electronic Submission 
Waived:  _____Yes  _____No
Public or private parks and playgrounds
5.1.4
Towers
5.2.1
7
4
5
2
9
5
122 Bloomingdale Road
997,525+/-
22.9+/-
R-40

Name: 
____________________________________ 
Applicant’s Authority to File Application5
Title: 
____________________________________  
Legal Owner of Record
Company: 
____________________________________ 
Power of Attorney 
Address: 
____________________________________ 
Contract to Purchase
City/State: 
________________________ 
__________ 
Other ________________________________ 
Zip Code: 
_______________ 
Telephone: 
_________________ 
Fax: 
___________________ 
Email: ________________________ 
Name: 
____________________________________ 
Specify Nature of Agent
Title: 
____________________________________  
Attorney 
Company: 
____________________________________ 
Civil Engineer
Address: 
____________________________________ 
Land Surveyor 
City/State: 
________________________ 
__________ 
Design Professional; ____________________ 
Zip Code: 
_______________ 
Other: _______________________________ 
Bar/License/Reg. No.:___________________ 
Telephone: 
_________________ 
Fax: 
___________________ 
Email: ________________________ 
Note: If landowner is an LLC, Corporation, Trust or other legal entity, attach the names, addresses and title of each 
member or officer, including agent(s). If same as applicant list ‘Same’. 
Name: 
________________________________ 
Name: 
________________________________ 
Title: 
________________________________  
Title: 
________________________________ 
Company: 
________________________________ 
Company: 
________________________________ 
Address: 
________________________________ 
Address: 
________________________________ 
City/State: 
________________________ 
______ 
City/State: 
________________________ 
______ 
Zip Code: 
_______________ 
Zip Code: 
_______________ 
Telephone: 
_______________ 
Telephone: 
_______________ 
Fax: 
_______________ 
Fax: 
_______________ 
Email: 
_______________ 
Email: 
_______________ 
5 Applicant must submit evidence attesting to the authority to file application (i.e. deed, option for purchase, etc.) 
2.
Applicant Information
3.
Agent Information; if applicable
4.
Property Owner(s) and Parcel(s) Information
Is owner co-applicant?       Yes        No
Williams Memorial Institute
182 Mohegan Avenue
New London
CT
06320
860-439-2786
-
mfader@williamsschool.org
Michael J. Ott, P.E., L.S.
Principal
Summer Hill Civil Engineers, P.C.
60 Wall Street P.O. Box 708
Madison
CT
06443
70082
203-245-0722
-
ottm@summerhillcivilengineers.com
Williams Memorial Institute
182 Mohegan Avenue
New London
CT
06320
860-439-2786
-
mfader@williams school,.org

Attached a typed statement of use in conformance with the Zoning Regulations as described in Section 22.4.2.  In addition 
include all hours and days of operation, size of buildings and number of stories, utilities servicing the parcel, variances 
received, number of employee and structures to be demolished. 
Attach a statement describing how the building and site design is compatible with the neighborhood, character of 
Waterford and Zoning Regulations. 
Attach a statement attesting to how the proposed use, zone change, amendment or design is consistent with the most 
recent adopted Plan of Preservation, Conservation and Development (the Plan).  Note relevant Plan section numbers and 
pages. 
Yes
No 
 
 
 
 
 
 
 
 
 
 
 
 % of Property
___
a.  Are inland wetlands present on site?   Total SF/AC
_____________/___________      
______ 
___
b.  Are tidal wetlands present on site? 
  Total SF/AC
_____________/___________      
______ 
c.  Are their known or suspected vernal pools on the property? 
 
d. CT DEEP NDDB: Are endangered, threatened or species of special concern suspected to be located on 
the property? Applicant must attach an 8 ½ x 11 map of the most current CT DEEP Natural Diversity 
Database with site clearly identified regardless of response provided. If you answered yes to item d.,
attach a letter from CT DEEP stating the name of the specie(s) that are suspected to be on the 
property. See Section 22 of the Zoning Regulations for additional information.
e.  Are floodplains or flood hazard areas on the property? 
 
Identify: ___________________________________________________________________________ 
f.  Is the property located within a local, state of national historic district?   
If yes identify district name:  ___________________________________________________________ 
g.  Does the site possess any structures or sites listed on the local, state or national register of historic 
landmarks?
If yes, identify: ______________________________________________________________________ 
8.
Natural and Cultural Resources
5.
Statement of Use
6.
Statement of Design Compatibility (Site Plans and Special Permits only)
7.
Consistency with Adopted Plan of Preservation, Conservation and Development (all 
applications) 
X
4.9
X
48,525
1.1
X
X
X
X
48,525
X

Yes 
No
a.
Is any part of the site within 500' of the Town line?  Which town: _________________________ 
b.
Will any egress or ingress for the property use streets within an adjoining municipality?
c.
Is any work proposed in wetlands or watercourses?  Explain in Statement of Use
d.
Is any work proposed within 100 feet of a wetlands or watercourse? Explain in Statement of Use
e.
Is any work proposed within a floodplain or flood hazard area? Explain in Statement of Use  
f.
Is public water available or proposed to the site?  Identify: ________________________________ 
g.
Are public sanitary sewers available or proposed to the site?  Identify: _______________________ 
h.
Is there a utility, drainage or other easement(s) on the site? Specify:_________________________ 
i.
Is open space proposed on the property?   
  Percent of property(s)
How much open space is proposed (SF/AC)? _________/_________  
_____ 
Use and purpose of open space: ______________________________________________________ 
Have previous permits been issued for the Property:
     Yes             No
(List singularly; attached additional pages if necessary)
Date Issued  
 
Issuing Agency  
 
Approved Use/Activity 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
__________ 
 
___________________  
___________________________________________________ 
9.
Additional Information
10.
Previous Land Use Permits Associated with the Property(s)
X
X
X
X
X
X
X
X
X
5-23-24
Conservation Commission
Inland Wetlands and Watercourses Permit No. C-24-03
9-10-24
Planning and Zoning Commission
Planning and Zoning Commission Application No. PL-24-13

Yes
No
a.
Is this application for a new zoning district and/or regulation not presently established within the 
Zoning Regulations?  If a new zoning district, distinguish type of zone proposed:
Fixed Zone
Floating Zone
Overlay Zone
Identify proposed zone name: ____________________________________________________ 
For new regulations, list proposed section number(s) and titles(s): 
i.
______________________________________________________________________ 
ii.
______________________________________________________________________ 
iii.
______________________________________________________________________ 
b.
Is this application an amendment to an existing regulation?  Attach proposed amendments, clearly 
noting any deletions, modifications or additions.  List sections proposed to be modified:
i.
______________________________________________________________________ 
ii.
______________________________________________________________________ 
iii.
______________________________________________________________________ 
c.
Is this application for a change to a district already established within the regulations?  Identify:
________________________________________________________________________________  
Supporting materials: 
For new zoning districts or a change in zone provide a legal description of the land involved in the zone district change
including the following:
x
Location map at 1”=1000’ 
x
Accurate description and acreage of tract(s) to be changed with existing buildings and uses 
x
Show existing features including but not limited to contours at two-foot intervals, wetlands and watercourses,
flood plains, all improvements and structures,   
x
All lots or parts of lots contained in an area within 500 feet in all directions of the zone change tract
x
All lots shown in this area and within the zone change tract shall contain the name and address of owners as 
recorded in the Assessor’s records and shall show the nature of use 
x
North point, and distance along road from nearest road intersection. 
x
Scale of map(s)
11.
Change of Zone, Regulation Amendment or New Zoning District, if applicable
X
X
X

Complete the following table, which must also be included on applicable drawings: 
Zoning District(s): ____________
Item
Required
Proposed
Minimum Lot Size
Frontage
Front Yard
Side Yard
Rear Yard
Building Line
Building Coverage
Parking6
Landscaping
Impermeable Coverage
                                                          
6 Attach method used to determine the number of parking spaces required. 
12.
Bulk Zoning Requirements Table
R-40
40,000 sf
997,525+/- sf
100 ft
175 ft
50 ft
-
25 ft
26 ft
50 ft
51 ft
-
-
20%
-
-
-
-
-
-
-

Provide a list of all professionals responsible for the project.  Additional pages attached, if necessary:
Yes   
  No
Discipline:
_______________________________ 
Telephone:
_______________________________ 
Name:   
_______________________________ 
Fax:
_______________________________ 
Company:
_______________________________ 
Email:
_______________________________ 
License(s)/
License(s)/ 
Accreditations: _______________________________ 
Accreditation No(s): ___________________________ 
Discipline:
_______________________________ 
Telephone:
_______________________________ 
Name:
_______________________________ 
Fax:
_______________________________ 
Company:
_______________________________ 
Email:
_______________________________ 
Licenses and/or  
License/
Accreditations: _______________________________ 
Accreditation No(s): ___________________________ 
Discipline:
_______________________________ 
Telephone:
_______________________________ 
Name:
_______________________________ 
Fax:
_______________________________ 
Company:
_______________________________ 
Email:
_______________________________ 
Licenses and/or  
License/
Accreditations: _______________________________ 
Accreditation No(s): ___________________________ 
Discipline:
_______________________________ 
Telephone:
_______________________________ 
Name:
_______________________________ 
Fax:
_______________________________ 
Company:
_______________________________ 
Email:
_______________________________ 
Licenses and/or  
License/
Accreditations: _______________________________ 
Accreditation No(s): ___________________________ 
Discipline:
_______________________________ 
Telephone:
_______________________________ 
Name:
_______________________________ 
Fax:
_______________________________ 
Company:
_______________________________ 
Email:
_______________________________ 
Licenses and/or  
License/
Accreditations: _______________________________ 
Accreditation No(s): ___________________________ 
13.
Planning, Design and Engineering Team
Land Surveying
Michael J. Ott, P.E., L.S., M.ASCE
203-245-0722
Summer Hill Civil Engineers, P.C.
ottm@summerhillcivilengineers.com
CT PE and LS 70082
Civil Engineering
Michael J. Ott, P.E., L.S., M.ASCE
203-245-0722
Summer Hill Civil Engineers, P.C.
ottm@summerhillcivilengineers.com
CT PE and LS 70082